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. 2024 May;3(5):100917.
doi: 10.1016/j.jacadv.2024.100917. Epub 2024 Mar 28.

Key Psychosocial Health Outcomes and Association With Resilience Among Patients With Adult Congenital Heart Disease

Jill M Steiner  1 , Katherine Nassans  2 , Lyndia Brumback  3 , Karen K Stout  2 , Chris T Longenecker  4 , Joyce P Yi-Frazier  5 , J Randall Curtis  6 , Abby R Rosenberg  7
Affiliations

Key Psychosocial Health Outcomes and Association With Resilience Among Patients With Adult Congenital Heart Disease

Jill M Steiner et al. JACC Adv. 2024 May.

Abstract

Background: Adult congenital heart disease (ACHD) can negatively impact quality of life (QOL). Strengthening resilience may improve this and other psychosocial outcomes important for living a meaningful life.

Objectives: The purpose of this study was to describe resilience and key psychosocial health outcomes in ACHD and evaluate the associations between resilience and these outcomes.

Methods: We conducted a prospective cohort study of outpatients with moderate or complex ACHD between May 2021 and June 2022. Participants completed surveys at baseline and 3 months, evaluating resilience (Connor-Davidson Resilience Scale-10), health-related QOL (EQ5D-3L, linear analog scale), health status (Euroqol visual analog scale), self-competence (Perceived Competence Scale), and psychological symptom burden (Hospital Anxiety and Depression Scale) and distress (Kessler-6).

Results: The mean participant age (N = 138) was 41 ± 14 years, 51% were female, and 83% self-identified as non-Hispanic White. ACHD was moderate for 75%; 57% were physiologic class B. Mean baseline resilience score (Connor-Davidson Resilience Scale-10) was 29.20 ± 7.54. Participants had relatively good health-related QOL, health status, and self-competence, and low psychological symptom burden and distress. Higher baseline resilience was associated with better values of all outcomes at 3 months (eg, 1 point higher resilience was associated with 0.92 higher linear analog scale; 95% CI: 0.52-1.32) with or without adjustment for demographics. After further adjusting for the baseline psychosocial measure, only the association between resilience and QOL measures at 3 months remained statistically significant.

Conclusions: Resilience is positively associated with health-related QOL for outpatients with moderate or complex ACHD, though relationships are small in magnitude. Study findings can guide the application of resilience-building interventions to the ACHD population.

Keywords: congenital heart disease; mental health; quality of life; resilience; well-being.

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Conflict of interest statement

This work was supported by NIH/NHLBI (K23HL15180 [to Dr Steiner]). REDCap is supported by the UW Institute of Translational Health Sciences, funded by UL1TR002319, National Center for Advancing Translational Sciences, National Institutes of Health. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Resilience and Key Psychological Health Outcomes in ACHD: Design and Primary Findings
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